Journal of Musculoskeletal Trauma

Clinical Features and Outcomes of Pelvic Insufficiency Fractures: Yong Min Seo, Young Chang Kim, Ji Wan Kim; J Korean Fract Soc 2017;30(4):186-191. Published online October 31, 2017; DOI: https://doi.org/10.12671/jkfs.2017.30.4.186

Abstract PDF: PURPOSE
The purpose of this study was to investigate the radiological and epidemiological characteristics, as well as the clinical course of pelvic insufficiency fractures in the elderly population.
MATERIALS AND METHODS
At a Haeundae Paik Hospital, we retrospectively reviewed patients with pelvic insufficiency fractures between March 2010 and May 2017. The demographic data of patients were analyzed, and bone mineral density and bone turnover markers were evaluated to estimate the metabolic status of the bone. The radiological characteristics were evaluated by comparing the simple x-ray images with the computed tomography images, and the types of fractures were classified via computed tomography images. For clinical course evaluation, we investigated comorbid complications, and compared the walking ability scale before and 6 months after the fracture.
RESULTS
A total of 42 patients were included, with an average age of 76.5 years. All were female except one case. In 5 cases where the initial medical examination was from another institution, the fracture was not found in 3 cases. All cases received conservative treatment. After the diagnosis of pelvic bone fracture using a simple x-ray imaging, additional fractures were found in 81.0% of the study population using a computed tomography. Initiation of gait occurred at an average of 2.8 weeks, and every case except 1 (97.6%) fully recovered their gait ability.
CONCLUSION
We concluded that there was a limitation with diagnosing pelvic insufficiency fracture using only a simple x-ray imaging technique. In general, cases in this study showed conservative treatment yielded favorable clinical outcome with relatively less critical complications.

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Oncogenic Osteomalacia with Multiple Insufficiency Fractures: A Case Report: Young Chang Park, Joon Oh Seo, Kyu Hyun Yang; J Korean Fract Soc 2017;30(3):146-150. Published online July 31, 2017; DOI: https://doi.org/10.12671/jkfs.2017.30.3.146

Abstract PDF: Oncogenic osteomalacia is a rare paraneoplastic syndrome, characterized by hypophosphatemia, renal phosphate wasting, osteomalacia, and multiple insufficiency fractures, as a result of the tumor. A wide excision of the causative tumor is considered as the treatment of choice, following which, a dramatic recovery is expected. Authors report a case in which the symptoms and bone mineral density were dramatically recovered after an excision of the causative tumor around the tibialis posterior muscle in oncogenic osteomalacia.

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Repetitive Insufficiency Fractures of the Femoral Shaft: A Case Report: Ji Hwan Kim, Young Ho Cho, Young Soo Byun, Jung Hoon Shin, Chung Yeol Lee, Tae Gyun Kim; J Korean Fract Soc 2010;23(1):109-112. Published online January 31, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.1.109

Abstract PDF: Stress fractures occur when the loads applied to a bone exceed the mechanical resistance and fall into two groups. Fatigue fractures, in which abnormal mechanical stress is applied to a normal bone, and insufficiency fractures, in which fracture occurs when stress of normal activity is applied to a bone that has decreased elastic resistance. Femoral shaft insufficiency fractures are reported rarely in patients with postmenopausal osteoporosis. We report a case of repetitive insufficiency fractures of the femoral shaft in 70 year-old female with marked osteoporosis.

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